Dong Quai / Angelica Sinensis

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Overview:

Dong quai (Angelica sinensis) root has been used for more than a thousand years as a spice, tonic, and medicine in China, Korea, and Japan. It is still used often in traditional Chinese medicine (TCM), where it is usually combined with other herbs. In TCM it is used most often to treat women's reproductive problems, such as dysmenorrhea (painful menstruation), and to improve circulation. Dong quai is sometimes called the "female ginseng." Although there are few scientific studies on dong quai, it is sometimes suggested to relieve menstrual disorders such as cramps, irregular menstrual cycles, infrequent periods, premenstrual syndrome (PMS), and menopausal symptoms.

Plant Description:
Dong quai grows at high altitudes in the cold, damp, mountains of China, Korea, and Japan. This fragrant, perennial plant -- a member of the celery family -- has smooth purplish stems and bears umbrella-shaped clusters of white flowers and winged fruits in July and August. The yellowish-brown thick-branched roots of the dong quai plant have several medicinal uses. It takes 3 years for the plant to reach maturity, after which the root is harvested and formulated into tablets, powders, and other medicinal forms.



Medicinal Uses and Indications:

Very few studies have been done looking at the use of dong quai in humans. Some lab tests suggest that dong quai contains compounds that may help reduce pain, dilate blood vessels, and stimulate and relax uterine muscles. More studies are needed to see whether dong quai is safe or effective.


Treatment:


Dong quai is sometimes suggested for the following conditions:

Menopausal symptoms

Some women report relief of symptoms such as hot flashes when taking dong quai. Researchers aren't sure whether dong quai has estrogen-like effects or if it blocks estrogens in the body, and the studies so far have been conflicting. One study found that dong quai did not help to relieve menopausal symptoms.


Other


Dong quai has also been suggested for these conditions, although scientific evidence is lacking:
    * Amenorrhea (absence of menstruation)

    * Heart disease -- One study suggested that when used in combination with Asian ginseng (Panax ginseng) and astragalus (Astragalus membranaceus), dong quai decreased symptoms of chest pain in a small group of people with heart disease.

    * High blood pressure


Dosage and Administration:

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day.


Dong quai is available in a variety of forms, including tablets and powders. Injections are used in China and Japan in hospital or health center settings. Homemade injections should never be used.


Dong quai should be stored in a cool, dry place.



Pediatric:

Dong quai should not be used in children because information on its safety is lacking.



Adult:

There is no recommended dose for dong quai, because information on its safety in humans is lacking.


Dried herb (raw root) may be boiled or soaked in wine before consuming.


Powdered herb (available in capsules). In one study for menopausal symptoms, 500 - 600 mg tablets or capsules were taken up to six times daily.


Tincture (1:5 w/v, 70% alcohol): 40 - 80 drops (equivalent to 2 - 4 mL, there are 5 mL in a teaspoon), three times daily.


Precautions:

You should not drink the essential oil of dong quai because it contains a small amount of cancer-causing substances.


Dong quai should not be used by those who have chronic diarrhea or abdominal bloating.


People who are at risk of hormone-related cancers, including breast, ovarian, and uterine cancers, should not take dong quai because researchers aren't sure if it has estrogen-like effects


Side Effects:
Dong quai, particularly at high doses, may increase your sensitivity to sunlight and cause skin inflammation and rashes. Stay out of the sun or use sunscreen while taking dong quai.



Pregnancy and Breastfeeding:

Dong quai should not be used during pregnancy because it may cause the uterus to contract and raise the risk of miscarriage. Nursing mothers should avoid dong quai because information on its safety is lacking.


Pediatric Use:

Children should not take dong quai because information on its safety is lacking.


Interactions and Depletions:
Dong quai may interact with the following medications and herbs:

Anticoagulants (blood-thinners) -- Dong quai may increase the effects of these drugs, including warfarin (Coumadin), and raise the risk of bleeding. The same is true of using dong quai with the herbs listed below. Talk to your doctor before taking dong quai with any of the following:
    * Feverfew (Tanacetum parthenium)

    * Garlic (Allium sativum)

    * Ginger (Zingiber officinale)

    * Ginkgo (Ginkgo biloba)

    * Ginseng (Panax ginseng)

    * Licorice (Glycyrrhiza glabra)

    * Chinese skullcap (Scutellaria baicalensis)

    * Turmeric (Curcuma longa)


Hormone medications -- There is little research on using dong quai with hormone medications -- such as estrogens, progesterones, oral contraceptives, tamoxifen, or raloxifene. But, because dong quai may have estrogen-like effects, you should not take it with hormone medications except under your doctor's supervision.


St. John's wort -- Both dong quai and St. John's wort can increase your sensitivity to sunlight. Talk to your doctor before taking them together.

Alternative Names:
Angelica sinensis; Chinese angelica; Danggui; Tan kue bai zhi; Tang kuei
    * Reviewed last on: 12/16/2008

    * Steven D. Ehrlich, NMD, private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.


Supporting Research:
Carroll DG. Nonhormonal therapies for hot flashes in menopause. Am Fam Physician. 2006;73(3):457-64.


Cho CH, Mei QB, Shang P, et al. Study of the gastrointestinal protective effects of polysaccharides from Angelica sinensis in rats. Planta Med. 2000;66(4):348-351.


Circosta C, Pasquale RD, Palumbo DR, Samperi S, Occhiuto F. Estrogenic activity of standardized extract of Angelica sinensis. Phytother Res. 2006;20(8):665-9.


Fugh-Berman A. Herb-drug interactions. Lancet. 2000; 355(9198):134-138.


Hardy ML. Herbs of special interest to women. J Am Pharm Assoc. 2000;40(2):234-242.


Kan WL, Cho CH, Rudd JA, Lin G. Study of the anti-proliferative effects and synergy of phthalides from Angelica sinensis on colon cancer cells. J Ethnopharmacol. 2008 Oct 30;120(1):36-43.


LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH:LexiComp; 2000: 425-426.


Smolinske A. Dietary supplement-drug interactions. J Am Med Womens Assoc. 1999;54(4):191-196.


Williamson JS, Wyandt CM. An herbal update. Drug Topics. 1998;142(6):66-75.


Wojcikowski K, Wohlmuth H, Johnson DW, Rolfe M, Gobe G. An in vitro investigation of herbs traditionally used for kidney and urinary system disorders: Potential therapeutic and toxic effects. Nephrology (Carlton). 2008 Sep 22. [Epub ahead of print]


Wong VK, Yu L, Cho CH. Protective effect of polysaccharides from Angelica sinensis on ulcerative colitis in rats. Inflammopharmacology. 2008 Aug;16(4):162-7.

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